This programmatic research continues to reflect the collaborative work of a group of investigators exploring the relationship of psychological factors to changes in health. The work in progress represents clinical studies in several specific areas: (1) Studies involving patients with cerebrovascular and/or cardiovascular disease with aa attempt to study differentiating personality haracteristics as well as psychosocial factors associated with the setting of disease onset, complications, sudden death and long-term follow-up; (2) coping patterns of patients undergoing adjustment to permanent cardiac pacemakers, cardia catheterization, hemodialysis and renal transplant, hysterectomy, early elective abortion, diagnosis and treatment of cancer; (3) ongoing study of the predictive relationships of hopelessness to carcinomatous changes in the uterine cervix and the psychosocial factors associated with leukemia and lymphomas, and (4) genetic counselling; (5) evaluation of the teachingof interviewing; (6) survey of patient needs and expectations and physician skills and qualifications in fee-for-service and prepaid primary care settings; (7) conservation-withdrawal; (8) long-term follow-up of psychological development after trauma in infancy.